Disseminated encephalomyelitis and multiple sclerosis: two different diseases – a critical review

  title={Disseminated encephalomyelitis and multiple sclerosis: two different diseases – a critical review},
  author={Charles M. Poser and Vesna V. Brinar},
  journal={Acta Neurologica Scandinavica},
  • C. Poser, V. Brinar
  • Published 1 October 2007
  • Medicine, Psychology
  • Acta Neurologica Scandinavica
The practice of initiating immunomodulatory treatment immediately after a clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS) emphasizes the need to distinguish between disseminated encephalomyelitis (DEM) and MS. Their clinical, genetic, imaging, and histopathological characteristics establish that they are distinct disease entities. Acute and recurrent DEM are more common in children, but also occur in adults. DEM is polysymptomatic and includes signs and symptoms rarely… 
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Acute disseminated encephalomyelitis
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The main features of ADEM are described, focusing in particular particular on the factors that influence its outcome and can guide the process of differential diagnosis.
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Consistent and unique MRS changes in metabolite ratios between the acute and chronic presentations of the disease were found and might assist in the early diagnosis of ADEM.
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    Seminars in pediatric neurology
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MS, ADEM, and the pertinent syndromic subtypes, their differential diagnosis, treatment, and prognosis are considered in this review.
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A number of recently conducted observational case series have substantially broadened the understanding about the clinical phenotype, diagnosis, and prognosis of acute disseminated encephalomyelitis.
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The authors suggest that a viral prodrome, early-onset ataxia, high lesion load on MRI, involvement of the deep gray matter, and absence of oligoclonal bands are more indicative of ADEM.
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Acute Disseminated Encephalomyelitis in Children: Discordant Neurologic and Neuroimaging Abnormalities and Response to Plasmapheresis
Presentation of ADEM with delayed development of MRI lesions in deep gray matter and brainstem may herald a prolonged clinical course and lack of response to glucocorticoid therapy.
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